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Background Acute respiratory infections (ARIs) are the leading cause for emergency presentation and a major driver for antibiotic use in children. In 2020, we established an ARI clinical registry to: evaluate clinical care for ARI to inform clinical guidelines; and as a platform for clinical trials assessing antimicrobial interventions. Methods Any child Results From Feb 2020-April 2021, 448 participants were enrolled (84% 0.05), in: children who received antibiotics versus those who did not (9.5 days vs. 8); children Conclusions Most children presenting to ED with ARI recover within 10 days. The length of recovery does not vary significantly by age, chronic illnesses, or antibiotic usage. Key messages Registry data provides baseline data to inform clinical trials assessing the role and duration of antibiotics for ARI.

Viral bronchiolitis is the most common cause of admission to hospital for infants in high-income countries. Respiratory syncytial virus accounts for 60-80% of bronchiolitis presentations. Bronchiolitis is diagnosed clinically without the need for viral testing. Management recommendations, based predominantly on high-quality evidence, advise clinicians to support hydration and oxygenation only. Evidence suggests no benefit with use of glucocorticoids or bronchodilators, with further evidence required to support use of hypertonic saline in bronchiolitis. Evidence is scarce in the intensive care unit. Evidence suggests use of high-flow therapy in bronchiolitis is limited to rescue therapy after failure of standard subnasal oxygen only in infants who are hypoxic and does not decrease rates of intensive care unit admission or intubation. Despite systematic reviews and international clinical practice guidelines promoting supportive rather than interventional therapy, universal de-implementation of interventional care in bronchiolitis has not occurred and remains a major challenge.

Background Despite international guidelines providing evidence-based recommendations on appropriate management of infants with bronchiolitis, wide variation in practice occurs. This results in infants receiving care of no benefit, with associated cost and is potentially harmful. Theoretical frameworks are increasingly used to develop interventions, utilising behaviour change techniques specifically chosen to target factors contributing to practice variation, with de-implementation often viewed as harder than implementing. This paper describes the stepped process using the Theoretical Domains Framework (TDF) to develop targeted, theory-informed interventions which subsequently successfully improved management of infants with bronchiolitis by de-implementing ineffective therapies. Explicit description of the process and rationale used in developing de-implementation interventions is critical to dissemination of these practices into real world clinical practice. Methods A stepped approach was used: (1) Identify evidence-based recommendations and practice variation as targets for change, (2) Identify factors influencing practice change (barriers and enablers) to be addressed, and (3) Identification and development of interventions (behaviour change techniques and methods of delivery) addressing influencing factors, considering evidence of effectiveness, feasibility, local relevance and acceptability. The mode of delivery for the intervention components was informed by evidence from implementation science systematic reviews, and setting specific feasibility and practicality. Results Five robust evidence-based management recommendations, targeting the main variation in bronchiolitis management were identified: namely, no use of chest x-ray, salbutamol, glucocorticoids, antibiotics, and adrenaline. Interventions developed to target recommendations addressed seven TDF domains (identified following qualitative clinician interviews (n = 20)) with 23 behaviour change techniques chosen to address these domains. Final interventions included: (1) Local stakeholder meetings, (2) Identification of medical and nursing clinical leads, (3) Train-the-trainer workshop for all clinical leads, (4) Local educational materials for delivery by clinical leads, (5) Provision of tools and materials targeting influencing factors, and prompting recommended behaviours, and (6) Audit and feedback. Conclusion A stepped approach based on theory, evidence and issues of feasibility, local relevance and acceptability, was successfully used to develop interventions to improve management of infants with bronchiolitis. The rationale and content of interventions has been explicitly described allowing others to de-implement unnecessary bronchiolitis management, thereby improving care.

Objective Abdominal pain is a common paediatric presentation to the ED. Accurate diagnosis of acute appendicitis is challenging, with the best-performing clinical scoring systems having sensitivities between 72% and 100%. The aim of this study is to assess the diagnostic accuracy of clinician gestalt according to seniority in diagnosing paediatric acute appendicitis in ED. Methods This is a prospective multi-centre observational study of clinician's prediction of appendicitis in children under the age of 16 years presenting to four EDs with abdominal pain over a 1 month period at each site. Clinician-estimated likelihood of acute appendicitis was compared with the final diagnosis determined by histopathology or operative findings and supplemented by telephone follow up for those without an operation. The primary outcome was diagnostic accuracy of clinician gestalt according to clinician seniority in diagnosing appendicitis. Results There were 381 children enrolled with completed clinician questionnaires, and 224 children had complete follow up or underwent appendicectomy. The median age was 9 years (interquartile range 6-12) and the incidence of appendicitis was 31/224 (13.8%, 95% confidence interval 9.3-18.4). The area under the curve (AUC), sensitivity, specificity, positive predictive value and negative predictive value of clinician gestalt were 0.84 (0.76-0.91), 81% (63-93%), 76% (69-82%), 35% (28-42%) and 96% (92-98%), respectively, giving an overall diagnostic accuracy of 76% (70-82%). AUC stratified by clinician seniority (junior, intermediate and senior) were 0.89 (0.80-0.98), 0.82 (0.69-0.95) and 0.76 (0.56-0.96), respectively. Conclusions The diagnostic accuracy of ED clinician gestalt in paediatric appendicitis is comparable to current clinical scoring systems irrespective of seniority.

Key Points Question Can the evidence-based treatment of infants with bronchiolitis be improved by using targeted interventions to deimplement low-value care? Findings In this international cluster randomized clinical trial of 26 hospitals and 3727 infants, an absolute risk difference favoring intervention hospitals was seen in compliance with 5 evidence-based recommendations in the treatment of infants with bronchiolitis. Meaning Use of targeted interventions improved the treatment of infants with bronchiolitis by deimplementing the use of ineffective and potentially harmful therapies and management; these results are important for bronchiolitis management, deimplementation science, and future interventions in acute care pediatrics., This cluster randomized clinical trial uses data from 26 hospitals to investigate whether evidence-based treatment of infants with bronchiolitis can be improved by using targeted interventions to deimplement low-value care., Importance In developed countries, bronchiolitis is the most common reason for infants to be admitted to the hospital, and all international bronchiolitis guidelines recommend supportive care; however, significant variation in practice continues with infants receiving non–evidence-based therapies. Deimplementation research aims to reduce the use of low-value care, and advancing science in this area is critical to delivering evidence-based care. Objective To determine the effectiveness of targeted interventions vs passive dissemination of an evidence-based bronchiolitis guideline in improving treatment of infants with bronchiolitis. Design, Setting, and Participants This international, multicenter cluster randomized clinical trial included 26 hospitals (clusters) in Australia and New Zealand providing tertiary or secondary pediatric care (13 randomized to intervention, 13 to control) during the 2017 bronchiolitis season. Data were collected on 8003 infants for the 3 bronchiolitis seasons (2014-2016) before the implementation period and 3727 infants for the implementation period (2017 bronchiolitis season, May 1-November 30). Data were analyzed from November 16, 2018, to December 9, 2020. Interventions Interventions were developed using theories of behavior change to target key factors that influence bronchiolitis management. These interventions included site-based clinical leads, stakeholder meetings, a train-the-trainer workshop, targeted educational delivery, other educational and promotional materials, and audit and feedback. Main Outcomes and Measures The primary outcome was compliance during the first 24 hours of care with no use of chest radiography, albuterol, glucocorticoids, antibiotics, and epinephrine, measured retrospectively from medical records of randomly selected infants with bronchiolitis who presented to the hospital. There were no patient-level exclusions. Results A total of 26 hospitals were randomized without dropouts. Analysis was by intention to treat. Baseline data collected on 8003 infants for 3 bronchiolitis seasons (2014-2016) before the implementation period were similar between intervention and control hospitals. Implementation period data were collected on 3727 infants, including 2328 boys (62%) and 1399 girls (38%), with a mean (SD) age of 6.0 (3.2) months. A total of 459 (12%) were Māori (New Zealand), and 295 (8%) were Aboriginal/Torres Strait Islander (Australia). Compliance with recommendations was 85.1% (95% CI, 82.6%-89.7%) in intervention hospitals vs 73.0% (95% CI, 65.3%-78.8%) in control hospitals (adjusted risk difference, 14.1%; 95% CI, 6.5%-21.7%; P

Objectives To examine the epidemiological and clinical characteristics of SARS‐CoV‐2‐positive children in Australia during 2020. Design, setting Multicentre retrospective study in 16 hospitals of the Paediatric Research in Emergency Departments International Collaborative (PREDICT) network; eleven in Victoria, five in four other Australian states. Participants Children aged 0‒17 years who presented to hospital‐based COVID‐19 testing clinics, hospital wards, or emergency departments during 1 February ‒ 30 September 2020 and who were positive for SARS‐CoV‐2. Main outcome measures Epidemiological and clinical characteristics of children positive for SARS‐CoV‐2. Results A total of 393 SARS‐CoV‐2‐positive children (181 girls, 46%) presented to the participating hospitals (426 presentations, including 131 to emergency departments [31%]), the first on 3 February 2020. Thirty‐three children presented more than once (8%), including two who were transferred to participating tertiary centres (0.5%). The median age of the children was 5.3 years (IQR, 1.9‒12.0 years; range, 10 days to 17.9 years). Hospital admissions followed 51 of 426 presentations (12%; 44 children), including 17 patients who were managed remotely by hospital in the home. Only 16 of the 426 presentations led to hospital medical interventions (4%). Two children (0.5%) were diagnosed with the paediatric inflammatory multisystem syndrome temporally associated with SARS‐CoV‐2 (PIMS‐TS). Conclusion The clinical course for most SARS‐CoV‐2‐positive children who presented to Australian hospitals was mild, and did not require medical intervention.

This article presents the view of three professionals and researchers in the translation field about the post-editing task with a view to examining what it is known about this relatively new task both in the localization industry and in the academic arena, as well as highlighting what should be investigated further in order to shed light on different aspects of post-editing and the use of machine translation. Aquest article presenta la visió de tres professionals i investigadors del camp de la traducció sobre la tasca de la postedició. L’objectiu és determinar què se sap sobre aquesta relativament nova tasca, tant per a la indústria de la localització com per a l’àmbit acadèmic. A més, es proposa posar de manifest aquells elements sobre els quals caldria fer més investigació per tal de posar el focus sobre diferents aspectes de la postedició i l’ús de traducció automàtica. Este artículo presenta la visión de tres profesionales e investigadores del campo de la traducción sobre la tarea de la posedición. El objetivo es determinar qué es lo que se sabe sobre esta relativamente nueva tarea, tanto para la industria de la localización como para el ámbito académico. Además, se propone poner de manifiesto aquellos elementos sobre los que habría que realizar más investigación para arrojar luz sobre diferentes aspectos de la posedición y el uso de la traducción automática.

Objective: Children frequently present with head injuries to acute care settings. Although international paediatric clinical practice guidelines for head injuries exist, they do not address all considerations related to triage, imaging, observation versus admission, transfer, discharge and follow-up of mild to moderate head injuries relevant to the Australian and New Zealand context. The Paediatric Research in Emergency Departments International Collaborative (PREDICT) set out to develop an evidence-based, locally applicable, practical clinical guideline for the care of children with mild to moderate head injuries presenting to acute care settings. Methods: A multidisciplinary Guideline Working Group (GWG) developed 33 questions in three key areas – triage, imaging and discharge of children with mild to moderate head injuries presenting to acute care settings. We identified existing high-quality guidelines and from these guidelines recommendations were mapped to clinical questions. Updated literature searches were undertaken, and key new evidence identified. Recommendations were created through either adoption, adaptation or development of de novo recommendations. The guideline was revised after a period of public consultation. Results: The GWG developed 71 recommendations (evidence-informed = 35, consensus-based = 17, practice points = 19), relevant to the Australian and New Zealand setting. The guideline is presented as three documents: (i) a detailed Full Guideline summarising the evidence underlying each recommendation; (ii) a Guideline Summary; and (iii) a clinical Algorithm: Imaging and Observation Decision-making for Children with Head Injuries. Conclusions: The PREDICT Australian and New Zealand Guideline for Mild to Moderate Head Injuries in Children provides high-level evidence and practical guidance for front line clinicians.

RationaleSevere acute paediatric asthma may require treatment escalation beyond systemic corticosteroids, inhaled bronchodilators and low-flow oxygen. Current large asthma datasets report parenteral therapy only.ObjectivesTo identify the use and type of escalation of treatment in children presenting to hospital with acute severe asthma.MethodsRetrospective cohort study of children with an emergency department diagnosis of asthma or wheeze at 18 Australian and New Zealand hospitals. The main outcomes were use and type of escalation treatment (defined as any of intensive care unit admission, nebulised magnesium, respiratory support or parenteral bronchodilator treatment) and hospital length of stay (LOS).Measurements and main resultsOf 14 029 children (median age 3 (IQR 1–3) years; 62.9% male), 1020 (7.3%, 95% CI 6.9% to 7.7%) had treatment escalation. Children with treatment escalation had a longer LOS (44.2 hours, IQR 27.3–63.2 hours) than children without escalation 6.7 hours, IQR 3.5–16.3 hours; pConclusionsOverall, 7.3% children with acute severe asthma received some form of escalated treatment, with 4.2% receiving parenteral bronchodilators and 4.3% respiratory support. There is wide variation treatment escalation.

This chapter presents translation as a form of human–computer interaction. The evolution of translator–computer interaction is explored, and the benefits and challenges from a cognitive and professional perspective are enunciated. Particular attention is given to the increasing use of machine translation (MT), the growing fuzzy boundary between translation memory and MT, and new modes of interaction such as adaptive MT and interactive MT. The concept of cognitive ergonomics is drawn on to argue for a more caring and inclusive approach towards the translator by developers of translation technology. A case is also made for wider acceptance by the translation community of the benefits of the technology at their disposal and for more humanistic research on the impact of technology on the translator, the translation profession and the translation process.

ObjectiveThe validated Predicting Abusive Head Trauma (PredAHT) clinical prediction tool calculates the probability of abusive head trauma (AHT) in children MethodsThis is a secondary analysis of a prospective multicentre study of paediatric head injuries conducted between April 2011 and November 2014. We extracted data on patients with possible AHT at five tertiary paediatric centres and included all children ResultsOf 87 ICI cases, 27 (31%) were positive for AHT; 45 (52%) were negative for AHT and 15 (17%) had indeterminate outcome. Using a probability cut-off of 50%, excluding indeterminate cases, PredAHT-2 had a sensitivity of 74% (95% CI 54% t o89%) and a specificity of 87% (95% CI 73% to 95%) for AHT. Positive predictive value was 77% (95% CI 56% to 91%), negative predictive value was 85% (95% CI 71% to 94%) and the area under the curve was 0.80 (95% CI 0.68 to 0.92).ConclusionPredAHT-2 demonstrated reasonably high point sensitivity and specificity when externally validated in an Australian/New Zealand population. Performance was similar to that in the original validation study.Trial registration numberACTRN12614000463673.

Translation technology includes a broad array of tools. Over the past decades, the translation profession has become highly technologized, necessitating the inclusion of translation technology teaching in undergraduate and postgraduate translation programmes. Translator competence models have also evolved over this period such that ‘technology-based' competence is one of five core competences now listed in the EMT competence model. Much of the research into the didactics of translation technology focus on attitudes to technology among students. In particular, attitudes to the ever-increasing usage of machine translation have received attention of late. In terms of objectives and learning outcomes, there appears to be some consensus that only teaching tool functionality is insufficient; a socio-critical approach is called for so students will understand why tools are used, what their benefits and drawbacks are, and when tools should or should not be used. The didactic approach tends towards socio-constructivism in general and, more recently, there is evidence of project and team-based learning. Getting the balance right between ‘lecture' format and ‘lab' format is challenging. Human resourcing for teaching translation technology presents an additional challenge not only because high levels of technical skills are required, but also because the technology evolves rapidly.

This paper reports on an empirical study that investigates the translation process in the workplace from a cognitive ergonomic perspective. In particular, the interaction between ten translators employed by a language service provider and the tools they deploy are examined. To that end, we recorded the translators’ workplace activities using keystroke logging, screen recording and eye tracking, combined with short retrospective interviews. We analysed their behaviour in terms of how they switched between the two screens on their desks, how they used different tools and where they invested their visual attention. Data related to productivity and quality are also presented. Among other findings, our data reveal that validation searches for terms and general expressions lead to considerable tool and task switching among professional translators.

Cochrane is a non-profit organization which mainly relies on volunteer health professionals for the production, simplification, evaluation, and multilingual dissemination of high-quality health content. The approach that Cochrane volunteers adopt for the simplification (or intralingual translation) of English health content is non-automated and involves the manual checking and implementation of plain language guidelines. This study investigated whether and to what extent the introduction of a controlled language (CL) checker - which would make the simplification approach semi-automated - increased authors' satisfaction and machine translation (MT) quality. Twelve Cochrane authors completed a standardized questionnaire and answered follow-up questions on their level of satisfaction and preferences. Forty-one Cochrane evaluators assessed the quality of the Spanish MT outputs of simplified texts. Authors showed a preference for the introduction of a CL checker. Differences in MT quality scores were slight.

The application of machine translation (MT) in crisis settings is of increasing interest to humanitarian practitioners. We collaborated with industry and non-profit partners: (1) to develop and test the utility of an MT system trained specifically on crisis-related content in an under-resourced language combination (French-to-Swahili); and (2) to evaluate the extent to which speakers of both French and Swahili without post-editing experience could be mobilized to post-edit the output of this system effectively. Our small study carried out in Kenya found that our system performed well, provided useful output, and was positively evaluated by inexperienced post-editors. We use the study to discuss the feasibility of MT use in crisis settings for low-resource language combinations and make recommendations on data selection and domain consideration for future crisis-related MT development.

Aim Bronchiolitis is the commonest cause of hospitalisation for infants. Evidence-based Australasian bronchiolitis guideline was developed and introduced in 2017. This audit was to determine if the knowledge translation process of the updated local tertiary hospital bronchiolitis guideline (based on the Australasian guideline) reduced unnecessary interventions. Methods A retrospective chart review of infants with bronchiolitis diagnosis during the pre-guideline (1 July to 31 August 2015) and post-guideline (1 July to 31 August 2017) period, with the primary outcome of the number/proportion of unnecessary interventions. Results Presentations between 1 July to 31 August 2015 (n = 465) were compared with 2017 (n = 343). There was no difference in undertaking chest X-ray (24 (5.2%) vs. 17 (5.0%), odds ratio (OR) 0.98 (95% confidence interval (CI) 0.71-1.35), P = 0.911), salbutamol (23 (4.9%) vs. 10 (2.9%), OR 0.86 (95% CI 0.65-1.13), P = 0.279), glucocorticoids (2 (0.4%) vs. 5 (1.5%), OR 1.89 (95% CI 0.83-4.31), p = 0.129), antibiotics (11 (2.4%) vs. 5 (1.5%), OR 0.86 (95% CI 0.65-1.15), P = 0.307) or nasopharyngeal aspirate (172 (37%) vs. 124 (36.2%), OR 1.00 (95% CI 0.87-1.67), P = 0.937) in hospital. Adrenaline was not administered in both years. There was reduced hospital admissions (303 (65.2%) vs. 192 (56.0%), OR 0.82 (95% CI 0.71-0.95), P = 0.008) with no difference in paediatric intensive care unit admissions (10 (2.2%) vs. 8 (2.3%), OR 1.04 (95% CI 0.65-1.67), P = 0.863). Conclusion The dissemination process of the updated local hospital bronchiolitis guideline did not show any statistically significant reduction of unnecessary interventions in the hospital. Further studies are required to determine the effective process to instigate changes in health services.

As access has grown to online courses in the form of MOOCs (Massive Open Online Courses), the language barrier has become an important issue for users worldwide. Machine translation (MT) appears to offer an alternative or complementary solution to existing forms of MOOC translation. Very little attention has been paid, however, to the use and utility of MT for MOOC content. The main goal of this research is to test the impact machine-translated subtitles have on Chinese viewers’ reception of MOOC content. We are interested in whether there is any difference between viewers’ reception of raw machine-translated subtitles as opposed to fully post-edited machine-translated (PEMT) subtitles and human-translated (HT) subtitles. Based on an eye-tracking experiment conducted at two Chinese universities and survey methods, we show that participants who were offered full PEMT subtitles scored better overall on our reception metrics than those who were offered raw MT subtitles. HT subtitles, on the other hand, did not necessarily lead to better reception as expected; in contrast, the participants who were offered HT subtitles performed the worst in some of our reception metrics.

In September 2015, the ADAPT Centre for Digital Content Technology carried out a focus group study of 70 translators at the European Commission’s Directorate-General for Translation (DGT). The aim was to better understand the factors involved in the translators’ adoption and non-adoption of machine translation (MT) during their translation tasks. Our analysis showed that, while broadly positive attitudes to MT could be observed, MT was not consistently adopted for all tasks. We argue that ergonomic factors related to a human translator’s needs, abilities, limitations, and overall well-being heavily impacted on participants’ decisions to use MT or not in their tasks. We further claim that it is only by taking into account the special institutional circumstances in which the activity of DGT translation is situated that these ergonomic factors can be fully understood and explained.

Today’s companies are overwhelmed with the need to create a huge amount of content, faster, customized, and for numerous media platforms, in order to support their products. Struggling with managing this amount of information, companies have now realised that the strategic management of multilingual enterprise content has become essential. Strategic management involves profiling content, its uses, its end readers and deciding what should be translated, into which languages, using which translation processes and technology. Profiling enterprise content is necessary in order to maximize the quality of the content and its translation at minimum effort and cost by reducing complexity. By targeting the audience, content could be categorized according to the expectation of the end-users, and so, different translation scenarios can be applied to different content types. This article will discuss the challenges of profiling content within the enterprise, as well as translation scenarios focusing on the decisions that push content in one or another direction.

Human rating of predicted post-editing effort is a common activity and has been used to train confidence estimation models. However, the correlation between human ratings and actual post-editing effort is under-measured. Moreover, the impact of presenting effort indicators in a post-editing user interface on actual post-editing effort has hardly been researched. In this study, ratings of perceived post-editing effort are tested for correlations with actual temporal, technical and cognitive post-editing effort. In addition, the impact on post-editing effort of the presentation of post-editing effort indicators in the user interface is also tested. The language pair involved in this study is English-Brazilian Portuguese. Our findings, based on a small sample, suggest that there is little agreement between raters for predicted post-editing effort and that the correlations between actual post-editing effort and predicted effort are only moderate, and thus an inefficient basis for MT confidence estimation. Moreover, the presentation of post-editing effort indicators in the user interface appears not to impact on actual post-editing effort.

In this study, we utilize the Socialization Influence Framework to examine how personal religiosity may influence adolescent dating dynamics. We conducted fifty in-depth interviews with adolescent females aged 15-18 attending high schools in a mid-Atlantic city. Six broad themes characterizing healthy dating dynamics were identified: Investment in the Relationship; Healthy Communications; Harmonious Interactions; Non-Destructive Dynamics; Relations with Family, Friends and Others; and Maintenance of Personal Integrity. Differences in characterizations emerged in relation to the degree of personal religiosity. Findings have implications for faith-based initiatives and efforts to promote positive youth development. The process by which internalization of religious beliefs may also translate into risk for unhealthy dating dynamics remains an important area of study.

Technology has had an important impact on the work of translators and represents a shift in the boundaries of translation work over time. Improvements in machine translation have brought about further boundary shifts in some translation work and are likely to continue having an impact. Yet translators sometimes feel frustrated with the tools they use. This chapter looks to the field of personalisation in information technology and proposes that personalising translation technology may be a way of improving translator-computer interaction. Personalisation of translation technology is considered from the perspectives of context, user modelling, trust, motivation and well-being.

Bronchiolitis is the most common reason for infants to be hospitalised. Over the past decade, the use of high-flow nasal cannulae (HFNC) therapy has increased markedly and it is now utilised not only in the intensive care unit setting but in general paediatric wards and emergency departments. The aim of this systematic review was to summarise and critique the current evidence-base for the use of HFNC in infants with bronchiolitis. We searched Ovid Medline, OvidEmbase, PubMed, Cinahl, Cochrane Library, Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials for systematic reviews and randomised controlled trials of HFNC therapy in infants with bronchiolitis from 1 January 2000 to 27 June 2018. We identified four randomised controlled trials (n = 1891) of HFNC in infants with bronchiolitis: three of these studies involved infants treated in emergency departments and inpatient paediatric wards in Spain, Australia and New Zealand, and one study involved infants treated in paediatric intensive care units in France. The findings of this review suggest that HFNC should be used as a rescue treatment for hypoxaemic infants who have not responded to standard sub nasal oxygen therapy. The use of HFNC for work of breathing in the absence of hypoxaemia, and severe disease, is not currently supported by the evidence, and should only be considered in the context of an appropriate research trial.

Background Bronchiolitis is the most common reason for admission to hospital for infants less than one year of age. Although management is well defined, there is substantial variation in practice, with infants receiving ineffective therapies or management. This study will test the effectiveness of tailored, theory informed knowledge translation (KT) interventions to decrease the use of five clinical therapies or management processes known to be of no benefit, compared to usual dissemination practices in infants with bronchiolitis. The primary objective is to establish whether the KT interventions are effective in increasing compliance to five evidence based recommendations in the first 24 h following presentation to hospital. The five recommendations are that infants do not receive; salbutamol, antibiotics, glucocorticoids, adrenaline, or a chest x-ray. Methods/design This study is designed as a cluster randomised controlled trial. We will recruit 24 hospitals in Australia and New Zealand, stratified by country and provision of tertiary or secondary paediatric care. Hospitals will be randomised to either control or intervention groups. Control hospitals will receive a copy of the recent Australasian Bronchiolitis Guideline. Intervention hospitals will receive KT interventions informed by a qualitative analysis of factors influencing clinician care of infants with bronchiolitis. Key interventions include, local stakeholder meetings, identifying medical and nursing clinical leads in both emergency departments and paediatric inpatient areas who will attend a single education train-the-trainer day to then deliver standardised staff education with the training materials provided and coordinate audit and feedback reports locally over the study period. Data will be extracted retrospectively for three years prior to the study intervention year, and for seven months of the study intervention year bronchiolitis season following intervention delivery to determine compliance with the five evidence-based recommendations. Data will be collected to assess fidelity to the implementation strategies and to facilitate an economic evaluation. Discussion This study will contribute to the body of knowledge to determine the effectiveness of tailored, theory informed interventions in acute care paediatric settings, with the aim of reducing the evidence to practice gaps in the care of infants with bronchiolitis. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12616001567415 (retrospectively registered on 14 November 2016).

Bronchiolitis is the most common lower respiratory tract disorder in infants aged less than 12 months, and research has demonstrated that there is substantial variation in practice patterns despite treatment being well defined. In order to align and improve the consistency of the management of bronchiolitis, an evidence-based guideline was developed for the Australasian population.The guideline development committee included representation from emergency and paediatric specialty medical and nursing personnel in addition to geographical representation across Australia and New Zealand - rural, remote and metropolitan. Formulation of the guideline included identification of population, intervention, comparator, outcomes and time questions and was associated with an extensive literature search from 2000 to 2015. Evidence was summarised and graded using the National Health and Medical Research Council and Grading of Recommendations Assessment, Development and Evaluation methodology, and consensus within the guideline group was sought using nominal group technique principles to formulate the clinical practice recommendations. The guideline was reviewed and endorsed by key paediatric health bodies.The guideline consists of a usable clinical interface for bedside functionality supported by evidence summary and tables. The Grading of Recommendations Assessment, Development and Evaluation and National Health and Medical Research Council processes provided a systematic and transparent process to review and assess the literature, resulting in a guideline that is relevant to the management of bronchiolitis in the Australasian setting.This is the first robust Australasian acute paediatric guideline and provides clear guidance for the management of the vast majority of patients seen in Australasian emergency departments and general paediatric wards with bronchiolitis.

Clear, timely and accurate information is recognised as strategically and operationally critical to disaster response effectiveness. Increasing cultural and linguistic diversity across the globe creates a demand for information to be available in multiple languages. This signifies a need for language translation to be a key element of disaster management. However, language translation is an underdeveloped tool in disaster management and has been a neglected topic in research. We analyse the disaster response approaches for five nations—Ireland, the UK, New Zealand, Japan and the USA—to determine the degree to which language translation is utilised. Taking the right to information as a starting point, we use a 4-A, rights-based analytic framework. Each approach is inspected for standards of Availability, Accessibility, Acceptability and Adaptability. The US has the strongest adherence to these standards while the other approaches are less developed. We suggest several principles for effective practice in providing language access services.

Scholars who need to publish in English and who have English as a Foreign Language might consider and already be deploying free online MT engines to aid their writing processes. This raises the obvious question of whether MT is actually a useful aid for academic writing and what impact it might have on the quality of the written product. The work described in this chapter attempts to address these two broad questions. After a brief introduction, Sect. 2 reviews literature on three topics: English as a lingua franca in academic writing and the consequences this might have for individual authors and for academic disciplines, second-language writing, and the use of MT as a second-language writing aid. In Sect. 3, the methodology is presented. As will be detailed, the experiment involved ten participants, who were asked to write an abstract in their field of expertise. One half of the text was written in English, while the other half was written in their L1 and then machine-translated into English. Section 4 describes the results: subjective feedback of the participants acquired through a post-task survey, revision activity of a professional reviser, number and types of errors identified by a grammar-checking tool. The results suggest that MT and self-post-editing did not impact negatively on the text produced. However, the participants were divided in their opinions about which task was easier and whether they would consider using MT again for academic writing support. In Sect. 5, we offer a discussion on those results and provide future research ideas.

This paper examines the relationship between translation and comprehension when communicating health-related information during a crisis. It tests comprehension levels among a population of rural and urban Kenyans of health-related crisis communication presented to them in an English source text and a Kiswahili target text. These data were gathered in Kenya in collaboration with a non-profit organisation, Translators without Borders, and the overarching aim of the project was to assess empirically the potential impact of translation on comprehension of health-crisis content. Findings indicate that English is not a suitable medium for the transfer of important health-related information among the cohort of participants in this study, despite English being an official language of Kenya. In contrast, Kiswahili, also an official language, seems to function well. As a result, a need for translation into Kiswahili in this context has been empirically shown. It was further found that written modes of communication are not necessarily the most appropriate modes for the dissemination of health-related crisis information among this cohort. This presents interesting challenges for governments, crisis response agencies, and translators alike, and these challenges are discussed.

Nous explorons dans cet article la pertinence d’utiliser la traduction automatique (TA) comme outil d’aide à la rédaction scientifique en anglais langue seconde (ALS). L’expérience, à laquelle ont participé dix chercheurs, comprenait deux tâches : la rédaction d’un texte en ALS et la rédaction d’un texte en langue maternelle. Ce dernier a ensuite été traduit automatiquement et post-édité par le participant. Par la suite, nous avons évalué la qualité linguistique des textes produits dans les deux situations, à partir d’une analyse des modifications linguistiques effectuées par une réviseure professionnelle. Selon nos résultats, la qualité linguistique des textes est sensiblement la même dans les deux situations, tandis que des différences apparaissent dans les dimensions linguistiques et dans les types d’unités touchées. L’article se termine par une réflexion sur les facteurs pouvant influencer ces résultats. Nous concluons en réitérant la pertinence d’étudier l’utilisation de la TA pour la rédaction d’articles en anglais de spécialité. In this paper, we investigate the use of machine translation (MT) as an aid for writing academic texts in English as a second language (ESL). We report on an experiment, which involved ten researchers and included two tasks: writing a text in ESL and writing a text in the mother tongue. The second text was subsequently machine translated and post-edited by each participant. We then analysed the types of edits made by a professional reviser and used our analysis to evaluate the linguistic quality of the texts produced in both conditions. According to our results, the linguistic quality of the texts is equivalent in both conditions, whereas some differences appear in the linguistic dimensions and in the types of units affected by the edits. The article ends with a reflection on the factors that could have influenced the results. We conclude by reaffirming the relevance of studying the use of MT in writing in English for specific purposes.

CAT tools have become a fixture of professional translation over the last two decades yet are still treated with suspicion or disinterest by many freelancers. Acknowledged to contribute to consistency and speed, they can constrain and otherwise negatively affect the translation process in various ways. Surveys of professional translators and observations at the workplace suggest that there is a degree of frustration associated with the use of CAT tools and room for improvement in their usability. A recent large-scale survey of professional translators included specific items for CAT tool users about whether any features of their tools were irritating or missing. Many reported that there were and also availed themselves of the opportunity to provide detailed comments about them. More than half of the CAT tool users said that they found some features irritating, and a quantitative and qualitative analysis of their comments revealed that the most common issues concerned the complexity of the user interface and segmentation. There were some differences in the responses between freelance, institutional and commercial translators but almost none across age groups. The comments about missing features also tended to be about making the tools easier to use. The focus in the survey reported here was on identifying negative aspects of tools with a view to mitigating them and tailoring the tools more to translators’ needs. However, there is also room for research exploring the positive aspects of tools in the interests of optimising their usability and reducing cognitive friction

Machine translation is increasingly being deployed to translate user-generated content (UGC). In many situations, post-editing is required to ensure that the translations are correct and comprehensible for the users. Post-editing by professional translators is not always feasible in the context of UGC within online communities and so members of such communities are sometimes asked to translate or post-edit content on behalf of the community. How should we measure the quality of UGC that has been post-edited by community members? Is quality evaluation by community members a feasible alternative to professional evaluation techniques? This paper describes the outcomes of three quality evaluation methods for community post-edited content: (1) an error annotation performed by a trained linguist; (2) evaluation of fluency and fidelity by domain specialists; (3) evaluation of fluency by community members. The study finds that there are correlations of evaluation results between the domain specialist evaluation and the community evaluation for content machine translated from English into German in an online technical support community. Interestingly, the community evaluators were more critical in their ratings for fluency than the domain experts. Although the results of the error annotation seem to contradict those obtained in the domain specialist evaluation, a higher number of errors in the error annotation appear to result in lower scores in the domain specialist evaluation. We conclude that, within the context of this evaluation, post-editing by community members is feasible, though with considerable variation across individuals, and that evaluation by the community is also a feasible proposition.

The purpose of this study was to identify factors associated with increased risk for lethal violence among ethnically diverse Black women in Baltimore, Maryland (MD), and the U.S. Virgin Islands (USVI). Women with abuse experiences (N = 456) were recruited from primary care, prenatal, or family planning clinics in Baltimore, MD, and St. Thomas and St. Croix. Logistic regression was used to examine factors associated with the risk for lethal violence among abused women. Factors independently related to increased risk of lethal violence included fear of abusive partners, posttraumatic stress disorder (PTSD), symptoms, and use of legal resources. These factors must be considered in assessing safety needs of Black women in abusive relationships.